Profession or discipline overview
To comprehensively understand the concept of healthcare, let us analyze briefly, the organization of the US health system. It primarily consists of health systems that are diversely complex in the manner in which they are organized. It is the responsibility of the federal government and local governments to distinctively define their roles in order to adequately protect the health of the general public (ICU, 2009). Therefore, the control of state public health departments is neither under the jurisdiction of the national government nor the federal government, but instead, greatly rests on the hands of the private sector. However, there is a connection between the direct healthcare services, governmental and nongovernmental services in terms of sharing of technical advice, public funds and regulatory standards to facilitate ideal care provision. Hence, the federal government is responsible for the management of different programs and overseeing research to ensure that health providers avail quality health through its department of health and consumer services (ICU, 2009). Hence, this strategy helps in ensuring that the health providers follow the correct care provision procedures, training and they obtain adequate funding for smooth running of those programs. Additionally, the government assures safety to citizens by providing health insurance, especially to vulnerable and disadvantaged groups with regards to poverty considerations, associated nature of disabilities and age (ICU, 2009). Succinctly, the government provides the insurances services to the elderly, the poor and the disabled. The other normal individuals obtain their health insurance from their respective employers. However, direct healthcare services are obtained from the private sector hospitals and clinics across the country in form of either primary, secondary of tertiary care. Additionally, the federal government provides financial assistance to the hospitals and clinics that provide care for the military, veterans and other Americans of diverse races.
Our major interest in this context is on leadership within the healthcare. Hence, a brief analysis of the human resources in this field in crucial. By 2004, the healthcare sector had approximately 17 million jobs. This accounted for nearly 2.4 million registered nurses while nursing aides were about 1.45 million among others like pharmacists, physicians and dentists. Hence, the sector grew significantly at a rate of 27% between 2004 and 2014 (ICU, 2009). The primary idea here is that the US population health is rooted on equity, cost, quality and access.
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Possible ethical dilemmas, brief description of these dilemmas
Ethical dilemma is a decision-making problem involving two moral imperatives that are equally important. Basically, the ethical dilemmas arise due to situational conflicts that result in transgressing one option by choosing another. Hence, it becomes a challenge in deciding which course of action is the best in the healthcare based on the consideration of the moral principles underlying in each one of them.
Therefore, there are a number of possible ethical dilemmas that doctors, physicians, patients and medical staff in general can come across in the healthcare sector. For instance, such dilemmas include informed consent, disclosing medical conditions, and competency levels (Hanson, 2014). The informed consent relates to the agreement between the patient and the doctor prior to performing a medical procedure. This will give the patient a humble time to rethink on the intelligent participation to make informed decisions and eventually consent to their treatment. This circumstance causes a state of limbo in the form of failure to make the right decision in case the doctor did not give a comprehensive explanation to the patient; a situation that may require the help of a nurse. The nurse will be faced with nurse’s dilemma since she/he must demonstrate the right levels of loyalty to both the patient and the medical provider throughout the process of solving the problem. Hence, this is a notorious health dilemma that needs respect for the patient’s interests and decisions and the correct application of the professional knowledge to achieve moral sense and sensitivity.
Again assessing competency is a notion in patients that sometimes make them ignore medical treatment and even refuse the application of common-sense advice in real life situations. This poses dilemma for medical practitioners. The incompetency can even be identified by another health care professional if his/her fellow provides inaccurate information to the patient; a fact that may later lead to detrimental effects. Yet, the patients have the rights to refuse the use of such medical directives provided by their providers; though this may be faced with repercussions. Hence, the ethical dilemma arising in this situation depends on whether the patient understands the possible repercussions of his/her behavior and whether the medical provider is competent or not. This explains how resolving the competing obligations becomes a problem in the healthcare sector due to the need to apply critical thinking skills creatively.
Also, disclosing the patient’s medical condition is a common ethical dilemma that most medical professionals face. Therefore, the doctors prefer the use of medical forms that the patient lists the names of individuals that will be permitted to access the medical conditions after conducting invasive procedures (Hanson, 2014). The ethical medical dilemma may arise due to failure to clearly indicate the person who will access the patient’s medical condition. As a result, the medical provider may decide to disclose the same to first-degree members of the family.
Identification of the most critical leadership ethical dilemma(s) to discuss and why (Pick up to three dilemmas to discuss)
There are two most critical ethical dilemmas in healthcare leadership. When healthcare leaders mislead and being a change agent pose critical challenges to the detriment of the patient in the health sector. For instance, some leaders may show shoddy behaviors at work, a fact that may compel other professional healthcare providers to make the right decision. This may occur due to the lack of exemplary ethical behaviors of those leaders owing to the notion of being above the law. Hence, they do not follow some of the ethical principles allied to the business. Other healthcare leaders have weaker values that do not enable them to avoid unnecessary succumb to temptations and eventually record shaky performances in the long run.
Again, change leadership is a critical ethical dilemma that leaders face in the healthcare sector owing to the question of whether the leader initiates positive change in the organizational context based on their individual professional capabilities (Veer, 2013). This relies on the levels of improvement that the leader brings to the organization depending on one’s professional qualifications and time available. Therefore, finding solutions to problems in the external environment and technological expansion leads to dilemma in the sense that the solutions may require advanced technology and render the traditional ones unethical. Hence, client privacy may be compromised in case of technological advances that may expose confidential information in the social media platforms that may cause great harm to the patients.
Discussion of ethical dilemmas: How is this leadership ethical dilemma?
Misleading leaders pose ethical dilemma in any healthcare organization. This is because the when leaders try to convince their fellows to follow some questionable strategies, they may actually make other employees question the competency of the leader and have the predicament of whether to resist or follow the boss’ instructions (Hanson, 2014). Hence, such reactions may lead to bad relationships between the healthcare employees and their leaders. Therefore, those who decide to follow the requirements of the boss will actually develop dishonest behaviors with poor confidentiality that does not allow for organizational success. As a result, the workplace environment will be highly unwelcoming to both the healthcare leader and the subordinates. Discriminatory comments may as well manifest themselves in form of the impacts of the misleading leadership and eventually cause poor relationships between the care providers and their patients.
Still, misleading leadership will simply make healthcare leaders view their professional carrier as a means of absorbing the existing values and culture of the organization; and curb changes that may lead to future progress. This is contrary to the organizational expectation that relies on learning of the norms to reform the whole healthcare system for future benefits. Therefore, misleading leadership lacks the needed extraordinary understanding of the professional requirements of the organization with regards to cultural norms (Veer, 2013). Hence, change still becomes the core responsibility of all employees rather than the top executives. Therefore, the leaders should make the right decisions to position their organizations at better places with respect to responsiveness to public concerns and the general social responsibility. With respect to ethical concerns, healthcare change agents may cause total derailment of the whole business due to their troublemaking perceptions.
Discussion of various ethical perspectives and this dilemma
Let us now consider the diverse ethical perspectives and change management in a healthcare organization. As aforementioned, a number of ethical dilemmas may arise independently without the consideration of the change agent’s qualifications (Hanson, 2014). Therefore, the executive healthcare management may hire external change agents to collect data and analyze them in order to lessen the impacts of an organizational issue. Therefore, the ethical recommendations require that the change management conform to the executive management agenda to successfully drive the organization to success. An ethical dilemma may arise in this case when the data collected and analyzed by the change agent does not align with the organizational agenda of its executives (Hanson, 2014). Hence, making a decision may pose a great challenge to the hired change agent (Veer, 2013). As a result, the change agent may manipulate data through crooked means to result in misconstructed statements that does not based the organization off power relationships to masquerade the scope of the change. Consequently, the change may lack proper decision for its choice; since the problem could have been based on performance metrics rather than shortage of employees. Therefore, the failure to accurately scrutinize the organizational problem in regard to its ethical problem may suffocate employees’ conformity to the change due to lingering questions on the competency of such scrutiny. Hence, a number of ethical concerns will arise within the healthcare sector as change agents will try to force conformity on their subordinates.
Ideally, ethical recommendations require that change agents develop the relevant organizational culture to initiate change within the healthcare system. Hence, ethics as it pertains to change management believes in adopting sets of organizational principles, values, and believes to align the behaviors and conducts of employees. Consequently, the employees will develop the culture of ethical behaviors as they attempt to lead by example towards initiating change (Veer, 2013). As they adopt the ethical codes of conduct, they reinforce the culture of ethical behavior that all other health professionals will adopt and the change will take place by itself rather than forcing subordinates to conform. Such ethical practices will be reflected in the departmental openness, constructive criticism, and clear communication that conforms to the organizational polices regarding how respect is maintained. Leading by example aside, there is need to establish codes of ethics to strengthen the existing relationship between the organizational ethical standards and employees beliefs. This way, the employees will be accountable for the ethical behaviors and the ethical culture will automatically initiate change without arising dilemmas related to change resistance.
According to ethics, misleading leaders have no place in the healthcare management system since they may cause dire consequences on the organizational performance. Therefore, ethical perspectives greatly rely on utilitarianism to motivate leaders to do their best for the maximum number of people they serve (National Collaborating Center for Healthy Public Policy, 2016). Therefore, leaders should consider both advantages and repercussions of both sides of the equally vital moral imperatives throughout the decision making process. Hence, the healthcare manager will be fully equipped with the best possible course of action towards the identification of comparative merits of action rather than misleading ideas.
Typically, the concept of utilitarianism in its regard to ethical perspectives requires that decisions regarding ethical choices should be based on the consequences of those choices. Based on philosophical perspectives of ethics, the best decisions yield the best outcomes rather than disadvantages in the general view of business organizations; and this is beneficial to the largest number of individuals (National Collaborating Center for Healthy Public Policy, 2016). Hence, healthcare leaders should put into consideration, both current and future consequences of making such ethical decisions to avoid instances of misleading leadership. This implies that making a choice regarding ethical standards in healthcare should involve the identification of all available and possible courses of actions as the decision maker weighs both the direct and indirect costs and benefits of the choices available. This will facilitate the adoption of the best alternative that will highly benefit the healthcare organization in accordance with the cost-benefit ratios identified.
References
Hanson, K. O. (2014). Verizon Visiting Professorship in Business Ethics. The Six Ethical Dilemmas Every Professional Faces. Bentley University Press. Retrieved 22/4/2017 from https://www.bentley.edu/sites/www.bentley.edu.centers/files/2014/10/22/Hanson%20VERIZON%20Monograph_2014-10%20Final%20%281%29.pdf
ICU. (2009). ICU Management & Practice, ICU: US Healthcare Overview. Blog. Volume 9 - Issue 2. Retrieved 22/4/2018 from https://healthmanagement.org/c/icu/issuearticle/us-healthcare-overview
National Collaborating Center for Healthy Public Policy. (2016). Utilitarianism in Public Health. Web. Retrieved 22/4/2017 from http://www.ncchpp.ca/docs/2016_Ethics_Utilitarianism_En.pdf
Veer, G. A. (2013). Organizational Change and Business Ethics. On the Influence of Change Paradigms on Change Managers’ Dealings with Ethical Dilemmas. Retrieved 22/4/2017 from https://dspace.ou.nl/bitstream/1820/8233/1/scriptie%20Glenn%20ter%20Veer.pdf
